Nursing Elites

1. When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?

• A. Anorexia
• B. Bradycardia
• C. Sudden relief from pain
• D. Decreased abdominal distention

Correct answer: C

Rationale: When caring for a child with probable appendicitis, sudden relief from pain is a critical sign that could indicate perforation of the appendix. Perforation results in the release of pressure and inflammation, leading to a temporary relief of pain. Anorexia (loss of appetite) and decreased abdominal distention are symptoms commonly associated with appendicitis itself, not perforation. Bradycardia (slow heart rate) is not typically a direct manifestation of appendicitis or its complications.

2. Which is the single most important factor to consider when communicating with children?

• A. Presence of the child's parent
• B. Child’s physical condition
• C. Child’s developmental level
• D. Child’s nonverbal behaviors

Correct answer: C

Rationale: The child’s developmental level is the most important factor, as it determines how information should be communicated and what the child can understand.

3. What is the most common piece of medical equipment that can transmit harmful microorganisms among patients?

• A. Thermometer
• B. Stethoscope
• C. Injection needle
• D. Disposable gloves

Correct answer: B

Rationale: The correct answer is B: Stethoscope. A stethoscope is commonly used between patients, and if not correctly disinfected, it can be a dangerous source of spreading microorganisms. Thermometers typically have barriers to prevent this type of transmission. Injection needles are discarded immediately after use and not reused, making them an unlikely source of transmission. Similarly, disposable gloves are not reused, so they are also not a common source of harmful microorganism transmission.

4. A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?

• A. Flank pain rarely occurs in children with renal injuries.
• B. Few nonpenetrating injuries cause renal trauma in children.
• C. Kidneys are immobile, well protected, and rarely injured in children.
• D. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.

Correct answer: D

Rationale: The amount of hematuria is not a reliable indicator of the severity of renal trauma, as even minor injuries can cause significant bleeding, while severe injuries may result in little or no visible blood. Renal trauma should be evaluated through imaging and clinical assessment.

5. A 3-year-old child, previously potty-trained, becomes a bed-wetter again during a hospital stay. Which explanation should the nurse provide to the parents?

• A. “Your child is no longer potty-trained and will need to be retrained when she goes home.”
• B. “The child may have developed a bladder infection in the hospital. I will notify the doctor.”
• C. “Preschool children may regress in their behaviors when they are ill in the hospital but should return to normal when they go back home.”
• D. “Don’t worry about it, she is fine.”

Correct answer: C

Rationale: During a hospital stay, preschool children may exhibit regression in behaviors such as bed-wetting due to stress. It is important for parents to understand that this behavior is a common response to the hospital environment and should resolve once the child is back home. Therefore, the correct explanation for the nurse to provide to the parents is choice C. Choice A is incorrect because it inaccurately states that the child is no longer potty-trained. Choice B is incorrect as it assumes a medical issue without evidence. Choice D is incorrect as it dismisses the parents' concerns without addressing the underlying cause of the behavior.

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